2013, 05-07 Permit App: BLD-2013-0825 Demo Residence>ValteyT
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenterCaspoka neva?Iev. orq
(Staff Use Only)
PERMIT NUMBER:
PERMIT FEE:
DEMOLITION PERMIT APPLICATION
PROJECT ADDRESS: 4-1 217 N en cc.) Nr1(c.`\L311/2 g92I6
ASSESSORS PARCEL NO.: ✓
BUILDING OWNER NAME: AI exist.) Y KU.2v\2_)C50
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MAILING ADDRESS: �I �) I V � �,(�G.\ j� �( G\
CITY:SeOVSCtF v\V C....\\ 2s `\ / I STATE: L.) ZIp: �-( 4' Z1 C
CONTACT` PERSON NAME: A \ enc s �Y`` `� ` - tv (LS. s a V
PHONE: FAX: CELL: S Dei 7`-{2_ `2 07 S 7
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
PROJECT DESCRIPTION (Please Provide Site Sketch)
:l:❑�' Site Plan Provided * ® Notice of Intent #
57/0 Spokane County Utilities has approved the disconnection
Describe the scope of work in detail
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DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction I5 to be done In full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permi is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and,qubsequently approved before this application can be processed.
Signature
Date: Si
Project # 61d—t 3-9z5
RECEIVED
MAY 0 7 2013
CSV PERMIT CENTER
SUB # I I J REV. #
Updated 1-11-11 Page 1 of 1
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Project # Bbl -13 <SZC
RECEIVED
MAY 0 7 2013
CSV PERMIT CENTER
SUS # r—r---J REV.
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